In percutaneous transluminal coronary angioplasty, it is customary to introduce a catheter into the femoral artery at an entry site in a patient's leg and to advance the catheter through the artery to the coronary region. The artery, which may be located one half inch or more beneath the skin, is punctured with a needle or similar device, and the catheter is inserted into the artery through a catheter introducer. Catheters typically have a diameter in the range between one millimeter and four millimeters, thus creating a significant puncture in the artery. The catheter is often twisted and otherwise manipulated as it is advanced to the treatment site, thereby causing a further enlargement of the puncture.
When the medical procedure is completed and the catheter is removed from the artery, it has been common practice to simply apply external pressure to the entry site until clotting occurs. The pressure can be applied manually by a nurse or by the use of sandbags. Often, a half hour or more is required before sufficient clotting occurs to remove the applied pressure. The time required to stop bleeding is not an efficient use of medical professional services. Furthermore, a bruise or hematoma often forms at the entry site, since internal bleeding of the punctured artery continues until clotting blocks the puncture.
A technique for coronary angioplasty wherein laser energy is directed through the wall of an inflated balloon in a stenosed region of an artery is disclosed in European Patent Application No. 182,689, published May 28, 1986. The laser energy fuses together fragmented segments of tissue in the stenosed region. U.S. Pat. Ser. No. 4,470,407, issued Sept. 11, 1984 to Hussein, discloses a laser endoscope having a transparent balloon and optical fiber means to irradiate the lumen of a body cavity such as a blood vessel, with laser energy. U.S. Pat. Ser. No. 4,672,969 issued June 16, 1987 to Dew, discloses a laser healing method in which a laser beam is used to heat biological tissue to form a "biological glue". Among the objects of the Dew patent is to provide an improved wound closure technique. However, none of the prior art known to applicant discloses a method for closing and sealing a puncture in an artery located beneath the skin after a catheter is removed from the puncture.
It is a general object of the present invention to provide an improved method for closing and sealing a puncture in an artery after a catheter or other medical device is removed from the puncture.
It is another object of the present invention to reduce the time required for treating a puncture in an artery after a catheter is removed from the puncture.
It is a further object of the present invention to provide a method for closing and sealing a puncture in an artery in which hematoma formation is reduced.
It is a further object of the present invention to provide a method for closing and sealing a puncture in an artery utilizing the simultaneous application of pressure and laser energy directly to the puncture site.